Dr. Emily's Blog

The Topsy Turvy World of Vaccines In 1993, after a failed attempt at health care reform, the Clinton administration passed the Vaccines for Children (VFC) program, a federally funded program that provides vaccines for uninsured and low income children at no cost to participating medical facilities. In a way, this program was a consolation prize for legislators who had to give up a much bigger vision for health care, and within its scope of action, the program has been a success. The support it has provided for clinics and private offices struggling under the burden of vaccine overhead has been invaluable. The way the program works is that the Center for Disease Control (CDC) buys vaccines at a discount, and distributes them to public health agencies who in turn give the vaccine to local clinics or private practices for distribution. The nurses and public health officials involved in the program are passionate about children’s health, and the program is run in a way that is helpful...

I heard on the radio that the first week of June has been designated national "Give-Someone-a-hug-Week". At first this sounds like it should be a good idea. Hugs are warm, fuzzy, touchy-feely things that allow us to break through inhibitory social barriers. However, upon further reflection, it becomes clear that indiscriminate hugging is not necessarily good. For example, an employer hugging an employee could be interpreted as sexual harassment and lead to a lawsuit. Hugging in the workplace could distract employees and decrease productivity. Hugging someone who doesn't want to be hugged can be a daunting proposition. He or she may be hard to catch, and may require a surprise hug. Certainly there are people who will take hugging to extremes.....hugging the mailman, the garbage man and so forth. Suppose Safeway (our local “friendly” grocery store) were to get wind of the hug craze? Can you imagine being asked "Paper, plastic, or a hug?" Others may stand in line...

Over the past 8 months, our office has successfully made the transition from paper to an electronic medical record (EMR). It has been exciting, but at times painful. All of us have had meltdowns, but we have also had a few delightful "ah-ha" moments. We are finally through the proverbial tunnel, almost into the light at the end of it, and that feels great. One impetus that helped trigger our decision to take the electronic plunge, was the promise of reimbursement through the American Recovery and Reinvestment Act of 2009 (ARRA), otherwise known as the stimulus plan. Starting in less than one year, physicians who demonstrate meaningful use of an EMR and have a significant population on Medicaid or MediCare will be eligible for large reimbursements from the federal government. If you are interested in taking advantage of this unique and generous program, I suggest getting started as soon as possible. Some of the criteria that constitute "meaningful use" are technol...

Last month I attended a conference entitled: Books, Memoirs and Other Creative Nonfiction at Harvard. It’s a great course, and I highly recommend this method of getting CME credit for writing, having fun, and networking with people in the publishing business. Self-help books, medical texts, and memoir comprise the 3 main categories of medical nonfiction. The publishing world is very interested in books that will sell lots of copies and make money. I don’t know why I was surprised by this. (We all need to get paid for our work.) Maybe it is because I live in a remote rural area, or that I have my head in the clouds. Naively, I figured the compensation for one’s writing would be roughly commensurate with the quality. I expected the publicists, agents, and editors to be interested in one’s prose, one’s command of the English language, and one’s writing style--but instead I found myself being asked about my TV appearances. Why would a writer want to appear on TV? If I wanted to be on TV, ...

Response to the North Coast Journal article on health care reform I am a local pediatrician and I really enjoyed reading Alan Sanborn's salient and entertaining article in favor of health reform. I, too, am an advocate of a single payer system because I can see no other way to improve care and contain costs. There is fat in the system, but it belongs to: INSURANCE COMPANIES (most of these companies keep about 20% of the premiums thay take in for themselves in the form of administartive costs and profit), MALPRACTICE LAWYERS and PHARMACUETICAL COMPANIES. Without fundamental reform, including tort reform, much of the money put into the system will not go towards health care essentials. To rebut Ron Ross, the comparison between running health care and running a company is not a comparison that works, because there are fundamental differences between some one with cancer who needs treatment, and some one who would like to mail a package (i.e. the Fed Ex example). Health ...

Anthem or Anathema? Healthy Families, a government program to provide health insurance to low income children is administered by Anthem Blue Cross, a for-profit insurance company. Last month, Anthem decided to offer new contracts to all Healthy Families providers paying roughly 1/3 the previous rates. In the setting of our national and state budget crisis, primary care offices were asked to accept drastic cuts in reimbursement rates, and many did. The California Medical Association (CMA) estimates that as many as 50% of the healthy families providers accepted the new, slashed reimbursement rates. The providers who refused to sign a fiscally impossible contract were subject to angry calls and tirades from scared and frustrated families, because (of course) Anthem let the physicians break the news to the patients. At our pediatric office patients cancelled numerous appointments, while others paid cash to have their children seen. Local families were unable to find providers who w...

Our household has had the dubious honor of being deeply and directly affected by some of the major initiatives contained in the economic stimulus package. My husband, who is a sales manager at Mid City Motor world has been working long, busy days trying to accommodate the rush of car buyers flooding in to take advantage of the “Cash for Clunkers” program, while our pediatric office, with the promise of future reimbursement for “meaningful use” of an EMR, has begun the process of converting to electronic medical records. The cash for clunkers program is meant to reduce carbon emissions by encouraging people to turn in gas guzzlers and purchase more fuel efficient vehicles, but questions remain as to the overall benefit. Cash for Clunkers does not reduce, recycle or reuse in the least. The clunkers must be destroyed and sent to landfills,—so no used vehicles come out of the transactions to sell again, and no parts can be gleaned for resale. Jobs involved with used car sales and p...